Blacks Hospitalized for COVID-19 Face Higher Odds of Death

“Because patients tend to go to hospitals near where they live, these new findings tell a story of racial residential segregation and reflect our country’s racial history that has been highlighted by the pandemic,” study coauthor, David Asch, M.D., the executive director of Penn Medicine’s Center for Health Care Innovation, said in a statement.

Asch noted a National Community Reinvestment Coalition study that found economic hardships persist in many of the majority Black neighborhoods that experienced “redlining” (systemic denials of home loans) decades earlier.

In a Washington Post column, Asch and Werner wrote that hospitals located in poorer neighborhoods tend to treat more patients who are uninsured or insured by Medicaid with inadequate reimbursement rates.

“In effect, doctors and hospitals in the United States are paid less to take care of Black patients than they are paid to take care of white patients. When we talk about structural racism in health care, this is part of what we mean,” they wrote.

In an editorial in JAMA Network Open that accompanied the study, David W. Baker, M.D., agreed that “a long legacy of structural racism” has contributed to the “financial challenges and limited resources” faced by many hospitals in predominantly Black communities.

Baker, an executive vice president at the Joint Commission, a leading organization in health care quality and patient safety located in Oakbrook Terrace, Illinois, noted that prior to the 1965 passage of Medicare, many hospitals would not admit Black patients.  

“Unfortunately, although the passage of Medicare integrated hospitals, there were no major policies or funding initiatives to ensure that the inferior conditions in hospitals that disproportionately cared for Black patients were rectified,” Baker wrote.

In their Washington Post column, Asch and Werner suggested that the federal government should focus more financial resources on hospitals serving lower-income and minority communities. In particular, they suggest raising Medicaid payment levels to Medicare levels and increasing payments to hospitals for uncompensated care provided to uninsured patients.

“Centuries of racism got us to this level of segregation and to these inequities in payment structure. Those enduring effects have played out in the setting of the COVID-19 pandemic, and they are no longer a mystery. These effects are predictable. But they are not inevitable. We can stop the cycle of disadvantage that perpetuates these inequities by adopting policies that directly invest in these communities and their hospitals,” they wrote.

Peter Urban is a contributing writer and editor who focuses on health news. Urban spent two decades working as a correspondent in Washington, D.C., for daily newspapers in Connecticut, Massachusetts, Ohio, California and Arkansas, including a stint as Washington bureau chief for the Las Vegas Review Journal. His freelance work has appeared in Scientific American, Bloomberg Government, and CTNewsJunkie.com.